The future is now: blood glucose meters keep getting smarter

Smaller. Faster. Smarter. We've come a long way since the days when glucose meters were the size of a portable tape recorder, and took several minutes to give you a reading. Back then, most meters had no memory. Information was recorded by hand.

"People had to go through several steps to do a blood glucose test," says Marcie Draheim, RN, CDE, past president of the American Association of Diabetes Educators. "They're not willing to do that anymore. They want to be once and done."

We've come a long way since then, and now, with approximately 75 meters on the market, the technology has become increasingly sophisticated, less painful and easier to manage.

Blood glucose meters keep getting better

For starters, today's glucose meters require less blood -- as little as 0.3 microliters will do for some -- which means testing is less painful. Many of them have significantly better memory, with the capacity to store thousands of readings.

Meters have also become more specialized. Backlight displays and audio capabilities on some meters for instance, can help people who have difficulties seeing. Other meters can function in higher temperatures, allowing users to travel to warm climates. In addition, some meters allow you to avoid painful fingersticks with alternative site testing that relies on blood taken from the forearm or the palm.

A growing number of meters are using wireless technology to interface with cell phones and computers, too. The technology allows meters to send results directly to your phone, so you can create charts, graphs and a logbook to track your blood glucose levels over time. Among the newest is the iBGStar from Sanofi-Aventis, which connects directly to your iPhone or iPod touch.

The information sent to your phone can be then transmitted to your physician's computer. And if you have the right app, the data from your meter can also help you plan your meals and create fitness routines.

Continuous glucose monitors keep watch all day long

At the same time, the use of continuous glucose monitors (CGM) is surging. CGMs are used primarily by people who require insulin. Because they can alert the patient to unexpected changes in blood glucose levels, they can help avert hypoglycemia. But they're also gaining popularity among people with type 2 diabetes.

"There's a big push to do continuous glucose monitoring," says W. Kenneth Ward, MD, principal investigator of the Artificial Pancreas Program at Legacy Research Institute. "There's a lot of concern that even if a patient does six or eight blood glucose measurements a day, it may not be enough to control blood sugar."

Ward says today's CGM's are more convenient, less cumbersome and less painful, though they do still require a blood glucose meter to calibrate the device and also to confirm the accuracy of a reading. The two CGM's on the market in the US (one made by Medtronic and the other by Dexcom) can communicate directly with a blood glucose meter. One, the MiniMed Paradigm REAL-Time Revel System, displays the CGM glucose readings on the insulin pump screen.

Newer models give patients greater control over their diabetes care. The Dexcom SEVEN Plus CGM now allows for seven days of uninterrupted wear. And just this year, Medtronic received approval from the US Food and Drug Administration to market the MySentry Remote Glucose Monitor, which will allow caregivers to monitor glucose levels in someone with diabetes from another room. An alert or alarm sounds when the person experiences a dip in blood sugar.

The future of blood glucose meters and CGM

Ongoing research promises to bring even more improvements to meters and CGMs. Among them include the following:

Easy Check breath glucose meter. Clinical trials are underway for this noninvasive glucose meter, which will measure glucose using the breath instead of blood.

The MiniMed Paradigm System featuring Low Glucose Suspend automation. The system allows the CGM to automatically adjust the delivery of insulin if glucose levels drop to a level defined as too low by the patient and his doctor. The system is available in 50 countries. Trials are underway in the US, where the system has not received FDA approval.

The Symphony system. At Echo Therapeutics, researchers are working on an above-the-skin CGM sensor. Unlike other CGMs, which measure glucose under the skin, the Symphony system uses a biosensor to read glucose levels through the skin before relaying information to a wireless remote monitor. Additional studies are needed before approval.

An artificial pancreas. For many researchers, the ultimate goal is a "closed loop," system that requires no human intervention. The key will be developing sensors that are accurate enough to eliminate fingersticks and allow insulin delivery to be automatically adjusted.

Article sources

Interview with W. Kenneth Ward, MD, Legacy Research Institute

About Winnie Yu

Winnie Yu has written about diabetes for various national magazines and websites including Diabetic Living, Woman's Day and WebMD. She is also the co-author of What to Do When the Doctor Says It's Diabetes. Her health writing has also appeared in Prevention, AARP Bulletin, Scientific American Mind, VIVMag and many other publications. She blogs at The Smart Mom Manual. Her new book, Autism, What Every Parent Needs to Know will be published in 2012 by the American Academy of Pediatrics.

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